Six Miami-Dade County residents have been indicted in connection with an alleged $10 million Medicare fraud scheme operated out of Midway Medical, a Miami clinic that purported to specialize in treating HIV/AIDS patients, Acting Assistant Attorney General Rita M. Glavin of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced.

Carmen Lourdes del Cueto, M.D., 65, Roberto Rodriguez, M.D., 54, Carlos Garrido, M.D., 69, Gonzalo Nodarse, 38, Alexis Carrazana, 41, and Alexis Dagnesses, 44, were all indicted by a grand jury in Miami on Feb. 12, 2009, for conspiracy to commit health care fraud. Del Cueto, Rodriguez, Garrido and Nodarse were also charged with conspiracy to launder health care fraud proceeds, as well as three counts each of substantive money laundering. The indictment seeks the forfeiture of assets from all named defendants.

According to the indictment, the three physicians, del Cueto, Rodriguez and Garrido, were part-owners of Midway Medical. Midway Medical purported to be an infusion clinic that specialized in providing infusions and injections to HIV-positive patients. The indictment alleges that the physicians ordered medically unnecessary infusions and injections, and falsified medical records to make it appear that the HIV services were necessary. The indictment also alleges that many of the infusions or injections were never actually provided.

The indictment also alleges that medical assistants Nodarse and Carrazana assisted the physicians in falsifying the medical records to make it appear that the services were needed. As part of the scheme, Dagnesses is alleged to have manipulated HIV-positive blood samples in order to obtain laboratory reports indicating that the patients had illnesses that they in fact did not have.

Del Cueto, Rodriguez, Garrido and Nodarse are further charged with distributing the proceeds of the fraud through a series of financial transactions involving more that $10,000 in tainted funds.

The indictment alleges that the physicians at Midway Medical billed more than $10 million to the Medicare program for services that were medically unnecessary and not actually provided between September 2002 and June 2005. During that time frame, Medicare paid more than $4.8 million on those fraudulent claims submitted by Midway Medical. If convicted on all charges, Del Cueto, Rodriguez, Garrido and Nodarse each face maximum prison sentences of 50 years. Carrazana and Dagnesses face 10 year maximum terms in prison.

An indictment is merely a charge and defendants are presumed innocent until proven guilty.

The case is being prosecuted by Trial Attorney John K. Neal and Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section. The case was investigated by the FBI and the Department of Health and Human Services, Office of Inspector General. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. Since strike force operations began in March 2007, 107 cases including 196 defendants have been indicted. Collectively, these defendants are alleged to have fraudulently billed the Medicare program for more than $600 million.

Source: U.S. Department of Justice


The final economic stimulus bill permits Americans’ personal health information to be exchanged and sold — without patients’ consent — for research and public-health purposes, warns the Institute for Health Freedom (Washington, DC) and Citizens’ Council on Health Care (Saint Paul, MN).

The bill also mandates the plan for each American to have a single electronic health record by 2014, without opt-out or patient consent provisions.

“This bill is very misleading because while it promises to outlaw the selling of data, the exceptions to the rule are huge and allow Americans’ personal health data to be exchanged and sold for research and public-health purposes without patients’ consent,” says Sue Blevins, president of the Institute for Health Freedom.

“This is a historical and unbelievable assault on the privacy rights of all Americans. Personal health information should not be exchanged and sold for research and public-health surveillance without patients’ consent,” stresses Twila Brase, president of Citizens’ Council on Health Care. “Patient data belongs to the patient. A pocket full of cash should not undo a patient’s right to protect their medical privacy.”

Blevins adds, “Most Americans have no idea that the so-called HIPAA privacy rule doesn’t give patients the freedom to give or withhold consent before their personal health information can be shared with others for many purposes. Digitizing people’s health records combined with allowing researchers and public-health officials to buy their data from doctors and health plans is going to pave the way for unconsented research on millions of Americans.”

These privacy advocates urge all Americans and policymakers to carefully examine the Final Conference Report, Part A on the economic stimulus bill, pdf page 296 (p. 11) and pdf pages 391-395 (pp. 106-110).

For more information, visit the websites of the Institute for Health Freedom (www.ForHealthFreedom.org) and Citizens’ Council on Health Care (www.cchconline.org).


The American Public Health Association (APHA) commends members of Congress for working together on the economic stimulus bill to produce legislation that will create jobs, allow state and local governments to continue offering critical safety-net services and provide an opportunity to work toward improving the health of all Americans.

The revised legislation includes funding for the following, all of which are supported by APHA as important opportunities to invest in both our economy and the health of our nation:

  • Prevention and Wellness Fund – These funds serve as an investment in prevention as an essential means to protect health in our nation and will help support the public health foundation that will be required for successful health system reform.
  • Safety Net Programs – The bill includes funding for Medicaid, COBRA, the Food Stamp Program and unemployment benefits. Each of these safety-net programs ensures that in these difficult times people are able to access health services and meet their other basic needs.
  • Public Health Work Force – Also included in the bill is funding to train and educate the public health professionals who are responsible for keeping us healthy. This essential funding will help lessen the impact of the current work force shortage and ensure that essential services continue across the nation.
  • Health Information Technology – These funds are directed at modernizing the health system to lower costs and provide health services more efficiently and accurately. These funds will not only help save money and create jobs, but they will also help save lives.

Along with other important components of the bill, these provisions serve as an important first step in ensuring that we have the healthy, productive work force that will be required as we move forward from these difficult times.

APHA looks forward to working with Congress throughout the appropriations process to ensure that our nation continues to recognize the essential nature of investing in our nation’s public health infrastructure.

Source: American Public Health Association


Millions Around World to Observe Rare Disease Day

  • Author: Health Informer
  • Filed under: Health News
  • Date: Feb 14,2009

The last day of February has been designated as worldwide “Rare Disease Day” to call attention to the public health issues associated with rare diseases, which affect nearly 30 million Americans and countless others around the world.

“People with rare diseases remain a medically underserved population in every country,” said Peter L. Saltonstall, president of the National Organization for Rare Disorders (NORD), which is sponsoring Rare Disease Day in the U.S. “This day is intended to bring together the patients and families with rare diseases to discuss the need for greater awareness, more research, and better access to diagnosis and treatment.”

More than 200 organizations, institutions and companies have signed on as “Rare Disease Day Partners” in a U.S. coalition supporting the special observance. The coalition, being coordinated by NORD, includes patient organizations, professional societies, government agencies, medical researchers, and pharmaceutical and biotechnology companies.

Rare Disease Day activities in the U.S. will include a nationwide network of online videos, patient stories and blogs; newspaper, radio, and television reports; state and municipal proclamations; a Rare Disease Hall of Fame for researchers; and other activities designed to raise awareness of what it means to have a rare disease.

A rare disease is one that affects fewer than 200,000 Americans. According to the National Institutes of Health (NIH), there are nearly 7,000 such diseases affecting nearly 30 million Americans.

“People with rare diseases often face challenges that occur less frequently with more common diseases,” Saltonstall said. “These include delay in getting an accurate diagnosis, few treatment options, and difficulty finding medical experts. Many rare diseases have no approved treatment, and insurance may not cover treatments that aren’t approved. Medical and social services may be denied because those making the decisions are not familiar with the diseases. Also, treatments for rare diseases tend to be more expensive than treatments for more common diseases.”

In 1983, the Orphan Drug Act was passed by Congress to create financial incentives for companies to develop treatments for rare diseases. Since then, nearly 330 “orphan” (for rare diseases) drugs and biologics have been approved by the U.S. Food and Drug Administration (FDA). FDA estimates that from 11 to 14 million Americans benefit from these products. However, that still leaves more than 15 million Americans with diseases for which there is no approved treatment.

Rare Disease Day also will highlight the unique partnership that exists among the patient community, government entities such as the NIH Office of Rare Diseases and FDA Office of Orphan Products Development, medical professionals, researchers, and companies developing orphan products.

Although this is the first Rare Disease Day observance in the U.S., it is the second globally. The concept was launched in Europe last year by the European Rare Disease Organization, EURORDIS, a sister organization to NORD. This year, Rare Disease Day also is being observed in other parts of the world, including Canada, Australia, and China. The plan is to have a global Rare Disease Day on the last day of February each year.

NORD, a federation of individuals and patient organizations, was established in 1983. It provides advocacy on behalf of the rare disease community; research grants and fellowships; educational services; and patient assistance programs.

For more information about Rare Disease Day activities in the U.S., go to NORD’s website (www.rarediseases.org). For information about the global observance, go to www.rarediseaseday.org.

Source: National Organization for Rare Disorders (NORD)


Categories

Archives

Blogroll

Meta